work-life balance

Tales of a Recovering Workaholic: Talking about the darker side of success

girlymicro Academic Life, Education, General, Healthcare Science, Leadership, Microbiology (Clinical) , , , , , , ,

I’ve been thinking a lot about pathways in healthcare lately, from having conversations about T-levels and apprenticeships this week, to equivalence and Higher Specialist Scientific Training (HSST) posts. It’s made me reflect a lot on my own training pathways and the fact that the majority of the advice I received was that the only option, in terms of approach, was to work harder and do more. Now, don’t get me wrong, there is some merit to that, and there is also some truth, but I had it drilled into me that you can’t be successful if you do a 9 – 5. You must always do more. You must always over deliver. You must always be adding to and diversifying your CV.

This advice and approach has been key to me developing into the person I am now. I am objectively successful and so grateful for the support I’ve received along the way. I have the long dreamed of Consultant post, and my dream job. I was made a professor within 10 years of finishing my PhD. I’ve held multi-million pound grants and have over 50 publications. The other side of the coin is that, despite being exhausted, I can never sleep for the number of things I haven’t finished, and I constantly feel like I’m not doing or achieving enough. I’ve also written before about the impact of my anxiety levels when I’m tired or try to step away. So, as new starter season comes upon us, I wanted to take a moment to really talk about the messages we are giving our trainees, and ourselves, to think about how true they are for current training opportunities and what we can do better for those that follow us.

Let’s start with a bit of history and the messaging that we used to focus on as part of training

Goal orientated view of the world

During my first week as a trainee Clinical Scientist, I was sat down and told that it was an 11 year training scheme to Consultant, but it was up to me to put in the work and make it happen. Well, I worked pretty damn hard, including not having a weekend off at one point for 3 years, and it still took me 16 years. Does that make me a failure? I don’t think so. Does that mean that I should have worked hard to make it happen in 11? I’m not sure of how I could. In fact, I don’t know of anyone who made it happen in 11 years. Of the 4 of us who started, only 3 are now Consultants, and we were a pretty committed bunch. So were we all set up to fail?

The whole scheme was designed with that 11 year target in mind. I understand it from a strategic point of view. There are a lot of boxes to be ticked. Our situation was made even harder as there were only 3 years’ worth of funding for a scheme that required 4 years of professional practice to gain registration. That meant you also had to prove yourself worthy and useful enough that someone would decide to fund you for that extra year. Otherwise, everything had been a waste, and you would walk away unregistered and unlikely therefore to get a job.

My main problem with this approach is that it doesn’t really allow scope for exploration, and it really doesn’t allow time for creativity. It trains you into the ‘onto the next thing’ approach. I certainly had no time for celebration or reflection between stages. I was always trying to make sure that I was useful enough to remain employed, and in later stages, as it took me 13 years to be made permanent, I had to also ensure I was bringing in sufficient money to cover my salary so I would be kept in a job. It also means that when you finally do get all those boxes ticked and get your dream job, you are so trained into the tick box way of life that you are left searching for what the next box should be, rather than embedding and celebrating what you have achieved.

There is nothing that cannot be fixed if you work hard enough

When I started work, I used to read a book at my desk during my lunchtime, like I had when I worked at Birmingham City Council. It would always be some variety of fiction novel. I came into work one day during my first few months, and a pile of textbooks had been left on my desk with a post-it note suggesting that maybe I should read these instead. The implication, to me, was that it was not acceptable to have downtime, that any moment I had should be used to continuously work and improve myself. In short,’I must try harder’ ‘I must work more’ in order to justify the privileged position I was in. If I wasn’t going to lunchtime talks, the time should be used for other improving activities.

I also remember clearly listening to amazing female Healthcare Scientists talking at events about how, to achieve as a woman, you always had to work harder and do more than anyone around you. It was made very clear that it was required to constantly go above and beyond if you wanted to reach their position, if you wanted to succeed, if you wanted to make a difference.

The messaging has always been pretty clear. No matter how hard you are working, it probably isn’t enough, and you must work harder. Otherwise, you will fail and let everyone who had faith in you down, as well as yourself. If experiments fail, you don’t go home, rest and reflect, and come back tomorrow. You stay and set it up again. There were just too many midnight finishes to count during my journey to Consultant. If you want it, you will just work harder until it happens. I submitted my PhD a year early in order to achieve FRCPath whilst on my fellowship. At the same time, I took a PGCert in education because I recognised that it was important for my career path and my interests. Looking back, doing those three things simultaneously was foolish beyond measure. At the time, I thought I was just demonstrating that I had what it took.

Effort must be continuous

At the very start of training, I remember sitting over a bunsen burner crying. I was so ill, but no one around me ever took any time off sick, and it was just not considered to be OK. Eventually, I was sent home as I just couldn’t breathe, but it was very much ‘see you tomorrow’. Having an ‘off day’ was not something that happened. The hard earned truth I’ve learned to accept is that my best looks different from day to day. Some days, I could take on the world. Other days, I struggle to crawl across the line at the end of the day. Especially with a health condition made worse by stress, the idea that I can just ignore it, carry on, and always achieve amazing things every day is sheer madness. This was how I tried to work, however, and it took seniority and growing older to come to terms with the fact that this was just not achievable.

The thing about seniority is interesting. There is something about seniority and being able to give yourself permission to do things differently, which is worth mentioning. That’s not the real difference, though. I think the real difference is in the expectation setting. I try to be the person who gives others permission to acknowledge that some days are harder than others. Who checks why people are still there when they should have gone home. Doing this for others has the side benefit of reminding me that sometimes it’s OK to also do this for myself. It is not possible, nor is it necessary, to work at 100% all of the time. There will be days when you absolutely need to bring it, but there will be recovery days when what you should do is catch your breath, and if possible, do some reflection in order to make things better long term. A career is a marathon and not a sprint, after all.

There is no room for failure

This one isn’t just a work thing. It’s definitely a family thing too. My father is infamous for saying that no child of his has ever failed anything, and we weren’t about to start now when I was worried about FRCPath.

The Clinical Scientist training programme has always been competitive. Getting into the programme was competitive,  but even when you were in it, my experience was that the programme itself was pretty competitive. The people on it were used to being at the top of their class, and I experienced a fair amount of posturing throughout my first 4 years. Far from being tackled and a focus placed in peer support and collaboration, I feel like the rhetoric around the programme added to this. The focus on there not being enough places for us all to get posts when we finished, and the constant commentary on only the best of the best being able to get Consultant posts, placed us in direct competition with each other from day one. Therefore, you couldn’t talk about challenges for fear of disclosing weakness that would impact your future. That atmosphere is one of the reasons I’m so passionate about talking about the reality of the job on this blog, both the highs and the lows, as I didn’t have any way to normalise my experiences when I was training and in the midst of them. I hope posting will help others in finding a benchmark for ‘normal’ that I didn’t have.

Even on a day to day basis failure was not an acceptable part of training. To this day, I remember that one of my fellow trainees reported a NEQAS result (part of a quality control scheme), and she got it wrong. The result got reported, and the department lost a point on the national scheme. In reality, it should have been checked by someone else before it went out, but it happened. The virology consultant at the time never spoke to them again. We would sit in joint tutorials, and he would ask a question, he would then wait for my response even if I was just repeating what my colleague just said. He would respond to my answer but not theirs. There was never a review of what had happened and how the mistake had occurred. There was no acceptance of the fact that being part of a quality scheme is there to support learning and to identify where improvements can be made. There was just a long-term change in the way that trainee was seen and how they were then supported. It was a clear demonstration of what would happen if a mistake was made and that it would impact how your working life would be from that point on.

Quitting is not an option

The same trainee went through a hard time during her final year. She basically spent a lot of her time crying, and the response was that she was allowed to come in 30 minutes late. She started to see a therapist, and even though we never met, I owe that therapist a lot. Her therapist pointed out that in the three years she had been in post she had never been out for a cup of tea with a colleague, so she was given homework to ask someone out for tea, and she asked me. This was a real turning point for me. We went for tea, and we had a real conversation about the things that were both hard and good. It was the first time that I felt less alone. It was also the start of a conscious decision I made to take people off site for tea, to support better conversations, that I’ve continued to this day.

Later that year, she walked away. She made a decision to go a different way. It took enormous strength to do it, and even now, I have enormous admiration for her. Until that point, I hadn’t known anyone make a decision that prioritised their wellbeing rather than the CV tick boxing. The general attitude was that Healthcare Science is a small world, and you were incredibly fortunate to be a part of it. It was so hard to get into, and you had put in so much that you would be crazy to walk away. There was judgement linked to failed experiments, let alone walking away from the programme. Seeing someone break that mould was incredibly powerful.

The truth is none of these messages are entirely true, so how do we do a better job of messaging for current training programmes?

Training is just that, a learning programme, a time to explore, fail, and reflect on those failures in order to learn to do things better. If the messaging I experienced as a trainee now feel less than ideal, what messages should we be encouraging? I’ve been having a think and these are some that I would like us to have better conversations about:

We are more than the sum of our qualifications

Not everyone is going to become a Consultant.  Not everyone is going to get FRCPath and a PhD. You know what, that’s perfectly OK. It doesn’t stop you aspiring for those things if that’s what you want. However, our trainees are not in a Hunger Games style competition to be the last one standing. More than that, how good you are at your job is not dictated by how many qualifications you pick up along the way. Some of the most amazing Biomedical Scientists I know and have the privilege to work with don’t have a masters degree. It’s OK to be a brilliant band 7, and be satisfied and fulfilled by the role you have. Your qualifications don’t define your worth, and it’s OK to make choices that aren’t about playing CV bingo. It is also OK to decide that those things matter to you, you still aren’t defined by them. They have the value you choose to give them.

It’s OK to pause and reflect

No career is a straight path, no matter how it looks from the outside. There will be bumps along the way and the odd hill/mountain to climb. You will reach the destination better for it. You will be able to handle the journey a whole lot better if you allow yourself time to pause and reflect along the way. A big part of development is about making time to reflect on where you are and where you are going to, but also asking the big questions about whether those decisions and reflections you’ve made previously are valid for where you are now. You will be working for decades, and the decisions you make in your 20s are unlikely to reflect the decisions you might make in your 40s, so making time for active reflection isn’t a luxury, it’s an essential part of a professional career.

Knowing when to change direction requires courage

In many ways, I’ve been pretty fortunate, the things that I’ve wanted have aligned with my values and have stayed pretty consistent. This could easily have changed, however. I suspect that if I’d been able to have a family, my focus may have altered somewhat. Knowing when to change your focus or direction is important. This a balancing act between knowing when you just need to double down because things are getting difficult, or when you have truly shifted as a person and that you have to change direction to reflect this. Mentorship and coaching can really help with both this and the reflection that may get you to that moment. Acknowledging that continuing down a path ‘just because’ may not be the right thing and that it requires courage to sometimes jump off a cliff and make a big switch is a step that may require additional support.

Your value is not defined by your productivity

This is the one that I struggle with most and therefore know I probably fail to provide the best leadership around. I often feel that ‘I’m do what I say’ not ‘do what I do’ in this area. I often feel defined by my to-do list, and when that gets out of control, as it often does, I place a LOT of judgement on myself. The thing is, if I get hit by a car tomorrow, no one is talking about my to-do list failures at my funeral. I hope that they will talk about how I made them feel, and maybe even this blog. It is hard, but we can choose what defines us. You have that power. One of the reasons this blog is ‘Tales of a recovering workaholic’ is because I recognise I need to change, and I’m hoping to do a better job of playing this on forward and encouraging our trainees to be defined as well rounded individuals with interests outside of work. We need to encourage a holistic view of value in ourselves and others.

There is no prize for working the hardest

The biggest lie I felt that was embedded in my original training programme was that if you just worked hard enough and ticked the required boxes, the prize was there at the end of the race. The hard truth is working hardest does not get you the job. Ticking all the boxes makes the outcome more likely, but it doesn’t guarantee you anything. There is no prize for the most midnight finishes. Trust me, I’ve done enough of them to know. To a certain extent, the prize for working hard is more work. If you set the bar at working most weekends, then your work just expands, so you have to work most weekends in order to keep on top of everything. If you require external validation, like me, this can be a really dangerous game to get into. If we see this in our trainees or ourselves, I think it’s important to recognise and actively find other ways to find that validation before it becomes built in or results in negative consequences.

The next generation of trainees deserve to benefit from the experiences of those that came before, both in terms of knowledge and in learning how we could do it differently. The working environment has changed, as have our trainees and training pathways. By thinking more about our messaging we can make the work place right now more suited to where we want it to be, rather than relying on chance to make it better. Everyone has a role to play, but we, as leaders and educators, should be prepared to lead by example and own the change we wish to see.

All opinions in this blog are my own

Understanding the Scope of Our Influence: Why we have to stop trying to ‘fix’ everything

girlymicro General, Leadership , , , , ,

I was having a retro moment recently, and I happened to hear The Mending Song from Bagpuss. It landed with me in a way that it hadn’t before. Many of us are ‘fixers’, that’s probably the reason we ended up working in healthcare. We are focussed on trying to make everything better, be that people, organisations, cultures or situations. There is no challenge that many of our ‘fix it’ nature’s won’t try to tackle.

This seemed especially poignant, as I posted last month about approaches when work life becomes challenging. A key aspect that struck me when I was writing that post was about really understanding what sits within our scope to impact and what doesn’t. There’s a really clear reason why it is important to understand this. If the thing you are trying to impact or ‘fix’ is outside your scope of impact or control, no matter how much you want it to be otherwise, you are setting yourself up for failure if your success criteria include change. You are setting yourself up for disappointment, stress, and frustration before you even start. This doesn’t mean that you can’t work to change your scope of influence or set a different set of success criteria, but that is really a different thing. If just just dive right in there, without first addressing this fundamental barrier, all you will impact is your blood pressure.

We will find it, we will bind it We will stick it with glue, glue, glue We will stickle it, every little bit of it We will fix it like new, new, new.

So, how do we understand what is in and out of our scope to impact or control. Well, there are layers to this, and it does truly depend on whether you are trying to influence or whether you are going as far as trying to control.

In terms of true control, the only person is we can exert that on is ourselves. Trying to control anything else sets us up for failure. So why did we try?

Impact and influence are a bit different. I think deep down we know the piece about control, but we are less good at having the conversation with ourselves about impact and influence. We start trying to ‘fix’ things and then see ourselves as failures when it doesn’t happen. The years during and since the pandemic have been a real life lesson in this area for me. So, in this post I’m going to talk about 6 areas where I’ve sought to undertake ‘the fix’, failed, and learnt why I’d set myself up with expectations that could not be achieved.

You can’t always ‘fix’ people

Throughout my life, I have been a somewhat collector of lost souls. From early boyfriends to PhD students who have had supervision issues, I’m a real believer that we should always be there for others and take situations as we find them, rather than judging based on hearsay or prior scenarios. Before I get started here, I’d like to say that I still strongly believe in this. What I have learnt the hard way though is that a certain percentage of time, the prior experiences of the person are so strong that patterns cannot be altered. If you take the open door approach, there will, therefore, be times when you can’t change the outcomes in the way you’d like.

When this happened to me recently, I wasted a lot of time agonising about what I should have done differently, where my flaws were in terms of response, where I had failed. I have come to realise that that time was wasted emotional energy that removed my focus from other important things. Don’t get me wrong, I think active reflection is always important, but there is a difference between that and entering into a self flagellation pity party. One is essential and productive, and the other leads to spirals and self recrimination.

Once I exited the spiral I realised I had fallen into thinking I had control rather than understanding my influence on another person, especially a person who is not a close friend or family, is always going to be highly limited. You can offer support, and you can change environments within your influence, but the person who actually has the control is the individual you are aiming to support. The work has to be done by them and not you. You can’t work harder as a surrogate for them.

As a result of this, I’m trying to be much more self-aware of where my control actually sits and using this to support my thinking in terms of boundaries and expectation setting. I’m giving myself permission to avoid entering into relationships that extend beyond support into ‘fixing’ territory. I’m also learning that this is important in maintaining my mental health and well-being. It is hard to see how badly those can be impacted until the situation is resolved, but I can’t help anyone else if I am not in a good space, and so sacrificing my mental well being is actually a short sighted response that leads to no one getting a good outcome in the end. It feels selfish, but sometimes you have to put yourself first.

You can’t always ‘fix’ situations

There are plenty of times when people come to you as someone in a leadership position and want you to ‘fix’ something. Sometimes, this is possible, often, more often than I’d hoped, you can make or help someone to make a step, but the ‘fix’ is out of your control.

On a large scale, I have previously written about some of the decision-making  during the pandemic. It was a really humbling and eye opening experience to discover how quickly scope of influence can expand and contract, and how much that scope of influence changes based on whether you are currently acting in the role of decision maker or not. Having people come to you and advocate for vastly different positions, combined with actually having a time limited ability to influence, made me realise how important it is to face up to the reality of where your scope lies. It also made me realise how much you may need to review where those zones lie in rapidly changing situations. Relationships and scopes of influence are never static and so always require periodic review, but this is even more important in changing or high stakes situations.

On a one to one level, I often experience this, not about organisational but about individual situations. A common one is the ‘I want to do a PhD’ approach. This happens multiple times each year. Sometimes, people just want more information about the pathway or what the options are. I’ve written a blog about this as I get asked the question a lot. Other times, it’s framed more like ‘what can you do to get me a PhD?’. In these circumstances, I give the information, but I often get stared at towards the end as if I’m not delivering. I then have to enter the discussion that acquiring a PhD is a self driven process and needs the individual to drive it. The same is true with a lot of postgraduate training pathways or career opportunities.  I can help and support, but I can’t do it for them. I can’t ‘fix’ the holes on CVs that need filling. Only they can do that. I can open doors, but they are the ones that need to choose to walk through them.

You can’t always ‘fix’ injustice

Sometimes, when I’m approached, it is about a situation, but just on the surface. When you dig deeper, it’s not about someone not stepping up and doing the work. It’s about a whole bunch of barriers they didn’t know about or haven’t been able to fix. Individuals either then reach out or I become aware, and of course, what I want to do is ride into those barriers, sledge hammer swinging, and break them down to bring equity and justice to the situation. This is definitely one where I thought, and do, have more influence over as I get more senior. The sad news is that although I can do more, I’m discovering I still can’t ‘fix’ everything.

I have a great number of examples on this one, anything from male colleagues not having to apply for or be interviewed for roles when female colleagues are made to jump through hoops, to scientists getting paid a third less to do the same jobs as medical colleagues. I wish I didn’t have so many, but if I started listing, I would be here all day.

So if I can’t fix it, what are my other routes of action. Well, firstly, writing things like this blog enables me to shine a light and at least raise awareness of the injustices I can’t ‘fix’. Then there are a whole bunch of active positions I can take with my leadership, even if the issue is too big for me to ‘fix’ alone. Actions such as advocacy and saying people names in rooms where they are absent in order to increase access. Being brave enough to call things out as they happen, challenging that misogynistic, racist or homophobic comment in the moment, and taking a stand. Being accountable and actively demonstrating my values, and by doing so, hopefully offering a safe space to those who might need it. Being there to support, whilst acknowledging that no sledgehammer wielded by a single person is going to be enough, so you have to lift up others so you can hammer those walls together.

You can’t always ‘fix’ cultures

Organisational cultures bring with them different values and different aims. They are complex and act almost like living beings, in that they develop and change over time. If ‘fixing’ individuals is difficult, then ‘fixing’ cultures can come with mind-boggling complexity.

One of the things I’ve found challenging is when I’ve been part of a group or organisation which started off with values that were completely aligned with my personal value set, which is the reason I joined, and then morphed into something where those two things were far from the same. It is also complicated even further when the espoused values do match, but the values demonstrated by the group decision making tell a different story.

There are a few different choices I’ve made at various points in my life and career, depending on how much continued participation mattered to me. The big one is always do you stay or do you go. Do you stay and try to influence internally, or do you call it quits and move on to something that is better aligned. The right decision, for me, is based on a) how committed you are to the purpose of said group and b) how much influence do you have to affect the change you want to make?

Large-scale organisations are even more complex as they not only have an overall culture,  but they will also consist of a number of smaller subcultures, which may be easier to change or influence. I count myself fortunate to be part of a team that I feel is super aligned with my values and beliefs. It hasn’t always been that way however. I’ve been part of other teams that haven’t been the same. On one occasion, many moons ago, my then team mates and I even had to escalate that we would leave if a change in leadership did not occur as the disconnect was so pronounced.  This was one of the most powerful examples of collective action I’ve been involved with, and it succeeded because our point of escalation was also aligned to our values and purpose. Knowing your scope of influence and the landscape you are navigating can therefore be incredibly powerful,  but understanding that scope is key to success.

You can’t always ‘fix’ the way others see the world

Firstly, and I cannot say this strongly enough, just because someone holds a different opinion, view, or vision of the world to you does not automatically make them wrong. There is room for diversity of thought in this world, and the very presence of that diversity makes us stronger as a whole. This is especially true when that diversity of thought is not causing anyone harm and drives us to better evolve our thinking in response.

The ‘not causing harm’ component of this one is key for me. If that world view is harming others by restricting access to care or opportunities, for example, I will always endeavour to challenge, as already discussed. What I’m having to learn, though, is that that challenge does not necessarily lead to changes in behaviour, no matter how many facts you put behind the discussion. Human beings are complex, and they have both intrinsic and extrinsic beliefs. Sometimes, it’s not even those that are proclaiming their beliefs that are the ones who are most firmly set in their world view and then it can be difficult to even identify where to start your discussions.

I think accepting our scope of influence in these cases is crucial to understand in order to not get disheartened.  In a world of spiralling conspiracy theories and loss of faith in science, it is important to know that it is not just a case of sitting someone down with a bunch of evidence and having a single good discussion. Changing someone’s beliefs or understanding of the world requires you to understand where the origin of those beliefs lies, and it may be no where near as obvious as we’d like to think. Additionally, long-term change is usually not seated in facts but in emotion, and that’s a whole different ball game that we may not be equipped to play.

Interestingly, for me, this ‘not causing harm’ component also extends to harm to self and links nicely back to not being able to change individuals. I’ve had people I’ve thought of as friends, who were so locked into self-destructive patterns of behaviour, based on their view that the grass was always greener elsewhere, that they couldn’t stay in any one situation long enough to start to ‘fix’ those patterns. I discovered the hard way that no matter the presented evidence you couldn’t get them to see the world in a different way. Sometimes, an external lens is just what someone needs to see themselves enough to spark change. Sometimes, that view is just so alien that discover you are not even speaking the same language.

You can’t always ‘fix’ yourself

Talking about changing people, we are not ourselves above having the same light cast upon us, and in theory, this is the one area where our scope should include control and not just variable levels of influence. The problem with discussion about ‘fixing’ ourselves is the mistaken assumption that some form of perfection can or will be able to exist. I have to tell you, as a recovering perfectionist, there is no such thing, and this is one of the biggest lies we tell ourselves. Worse than that, by aiming for such a lie, we set ourselves up to fail, over and over again.

None of us are, or can be perfect, we are constant works in progress. Perfection indicates some form of static existence,  whereas that cannot be the reality. Life is change, and we need to change and adapt with it. We learn and grow, and with that comes failure and the ability to do better next time. So my view on this has become: accept your flaws, and own your areas for improvement. After all, we are humans, not machines. The most powerful thought that I’m striving to embed is that I need to acknowledge there is sometimes beauty in both the flawed and the broken. If it is necessary for me to ‘fix’ parts of myself, as part of striving for improvement and healing, it is because I am better for it rather than because of punishing myself with the myth of perfection.

The one thing I hope we all take away from this blog is to not confuse the reality that change is outside of our area of influence with powerlessness. We always have the power to change. To change ourselves, to change our scope of influence, and eventually, if it matters enough, to work towards collective bigger change. Until then, treat yourself with the compassion that you would offer others and learn to not set yourself up for failure and distress by understanding where your current boundaries and influence lie. Stop trying to ‘fix’ what cannot be fixed, and try learning to love the flawed and different when it is right to do so.

All opinions in this blog are my own